Medicare Compliance & Reimbursement

The Centers for Medicare & Medicaid Services (CMS) has finally released the 2013 Physician Quality Reporting System (PQRS) incentive payments, and if the number is lower than you expected, you can look to the sequestration pay cuts for the answer.

“As required by law, President Obama issued a sequestration order on March 1, 2013,” CMS said in a Sept. 26 announcement. “Under these mandatory reductions, PQRS incentive payments made to eligible professionals and group practices have been reduced by two percent. This two percent reduction affected PQRS incentive payments for reporting periods that ended on or after April 1, 2013. All 2013 incentive payments are subject to sequestration.”

If you want a more in-depth analysis of your PQRS payment, visit the CMS website at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/AnalysisAndPayment.html.

Follow 4 Expert Tips to Prevent This Type of Breach

The latest HIPAA breach is the largest ever, affecting millions of patients across more than half of the United States. And this is the type of breach that strikes fear into the hearts of many healthcare providers — find out why and what you can do right now to avoid the same disaster. 

Background: Tennessee-based Community Health Systems, Inc. (CHS) has reported the breach of approximately 4.5 million patients’ personal information, including patient names, addresses, Social Security numbers, telephone numbers, and birthdates. The hackers accessed the patient records in the CHS system in April and June 2014. The affected patient population spans 28 states.

This type of massive, sophisticated data breach may seem impossible to prevent — but you can actually avoid it by taking a few simple steps. Attorney Casey Moriarty offered the following tips in an Aug. 19 Ogden Murphy Wallace Attorneys health law blog posting:

1. Safeguard & Educate: This large breach is yet another reminder to safeguard your electronic systems and educate your staff members on security policies and procedures.

2. Watch Staff Emails: The type of malware that caused this breach is relatively easy to overlook. A staff member who clicks on a link in an email or responds to an email from hackers who pose as security personnel could result in unknowingly installing the malware.

3. Use Encryption: Consider employing encryption technology that meets the HIPAA breach safe-harbor standards to avoid or mitigate this type of breach.

4. Check with IT: When staff members are in doubt about a suspicious email, phone call, or other communication, instruct them to always check with your information technology (IT) personnel and your HIPAA Privacy Officer before taking any action.